Provider Demographics
NPI:1356599799
Name:CARVER, CARLA JEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:JEAN
Last Name:CARVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JEANNIE
Other - Middle Name:
Other - Last Name:LIPSCOMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2118 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3964
Mailing Address - Country:US
Mailing Address - Phone:615-384-3203
Mailing Address - Fax:615-384-7124
Practice Address - Street 1:2118 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-3964
Practice Address - Country:US
Practice Address - Phone:615-384-3203
Practice Address - Fax:615-384-7124
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist